Anatomy
1 questionsWhich nucleus is primarily involved in the Papez circuit?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 361: Which nucleus is primarily involved in the Papez circuit?
- A. Pulvinar nucleus
- B. Intralaminar nucleus
- C. Anterior nucleus of the thalamus (Correct Answer)
- D. Ventral posterolateral (VPL) nucleus
Explanation: ***Anterior nucleus of the thalamus*** - The **anterior nucleus of the thalamus** is a key relay station in the Papez circuit [1], receiving input from the mamillary bodies and projecting to the cingulate gyrus. - This circuit is crucial for **memory formation** [2] and emotional processing. *Pulvinar nucleus* - The pulvinar nucleus is primarily involved in **visual processing**, attention, and eye movements. - It does not form a direct part of the classic Papez circuit for emotion and memory. *Intralaminar nucleus* - The intralaminar nuclei are involved in **arousal**, attention, and pain perception, with widespread projections to the cerebral cortex [1]. - They are not considered a primary component of the Papez circuit. *Ventral posterolateral (VPL) nucleus* - The VPL nucleus is a major **somatosensory relay** in the thalamus, transmitting touch, proprioception, and vibration information from the body to the cortex. - It has no direct role in the Papez circuit or limbic functions.
Biochemistry
3 questionsWhich of the following is a neutral amino acid?
Krabbe's disease is due to deficiency of ?
Hexokinase is inhibited by?
NEET-PG 2013 - Biochemistry NEET-PG Practice Questions and MCQs
Question 361: Which of the following is a neutral amino acid?
- A. Aspartate
- B. Arginine
- C. Glycine (Correct Answer)
- D. Histidine
Explanation: ***Glycine*** - **Glycine** has a hydrogen atom as its side chain, making it the **simplest amino acid** and electrically neutral at physiological pH. - Its **nonpolar side chain** contributes to its neutral charge and allows it to fit into various protein structures. *Aspartate* - **Aspartate** is an **acidic amino acid** with a carboxyl group in its side chain. - This **carboxyl group** can lose a proton, giving aspartate a net negative charge at physiological pH. *Arginine* - **Arginine** is a **basic amino acid** characterized by a guanidinium group in its side chain. - The **guanidinium group** contains multiple nitrogen atoms that can accept protons, making arginine positively charged at physiological pH. *Histidine* - **Histidine** is classified as a **basic amino acid** due to the imidazole ring in its side chain. - The **imidazole ring** has a pKa close to physiological pH, allowing it to be protonated and positively charged, but it is not neutral.
Question 362: Krabbe's disease is due to deficiency of ?
- A. Sphingomyelinase
- B. Beta galactocerebrosidase (Correct Answer)
- C. Hexosaminidase
- D. Arylsulfatase
Explanation: ***Beta galactocerebrosidase*** - Krabbe's disease is specifically caused by a deficiency of **beta-galactocerebrosidase**, leading to the accumulation of toxic substances in the brain [1]. - This disease predominantly affects the **myelin sheath**, resulting in severe neurological deterioration [1]. *Arylsulfatase* - Deficiency of **arylsulfatase** is associated with **metachromatic leukodystrophy**, not Krabbe's disease. - Symptoms and pathology differ significantly, primarily affecting **sulfatides** rather than galactocerebrosides. *Sphingomyelinase* - A deficiency of **sphingomyelinase** is linked to **Niemann-Pick disease**, characterized by splenomegaly and liver involvement. - This condition does not involve the same neurological deterioration seen in Krabbe's disease. *Hexosaminidase* - Hexosaminidase deficiency is associated with **Tay-Sachs disease**, primarily affecting the **GM2 gangliosides** [2]. - This results in different clinical manifestations, such as **cherry-red spots** and progressive neurodegeneration, rather than the symptoms of Krabbe's disease [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1304-1305. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, p. 161.
Question 363: Hexokinase is inhibited by?
- A. Glucose-6-phosphate (G6P) (Correct Answer)
- B. Glucose
- C. Insulin
- D. Glucagon
Explanation: ***Glucose-6-phosphate (G6P)*** - Hexokinase is subject to **feedback inhibition** by its product, **glucose-6-phosphate**, preventing the accumulation of high levels of G6P inside the cell. - This regulatory mechanism ensures that glycolysis does not proceed unchecked when energy needs are met or when G6P levels are already sufficient. *Glucagon* - **Glucagon** is a hormone that generally promotes **glucose production** and release, primarily by stimulating gluconeogenesis and glycogenolysis, rather than directly inhibiting hexokinase. - Its effects on glucose metabolism are more about increasing blood glucose levels than directly regulating the initial step of glycolysis in most tissues. *Glucose* - **Glucose** is the **substrate** for hexokinase, meaning it is the molecule that hexokinase acts upon to convert it into glucose-6-phosphate. - Therefore, glucose does not inhibit hexokinase; instead, its presence is necessary for the enzyme's activity. *Insulin* - **Insulin** is a hormone that promotes **glucose uptake** and utilization by cells, often by increasing the number of glucose transporters on cell surfaces. - While insulin can indirectly influence glycolysis by increasing glucose availability, it does not directly inhibit hexokinase; rather, it generally supports cellular glucose metabolism.
Internal Medicine
1 questionsCerebellar damage causes all of the following except?
NEET-PG 2013 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 361: Cerebellar damage causes all of the following except?
- A. Ataxia
- B. Past-pointing
- C. Dysmetria
- D. Hypertonia (Correct Answer)
Explanation: ***Hypertonia*** - Cerebellar lesions typically lead to **hypotonia**, a decrease in muscle tone, rather than hypertonia [1]. - Hypertonia, or increased muscle tone, is more commonly associated with lesions of the **upper motor neurons** or **basal ganglia** [2]. *Dysmetria* - **Dysmetria** is a common sign of cerebellar damage, characterized by an inability to accurately control the **range, direction, and force** of muscle movements [1]. - This leads to overshooting or undershooting a target during voluntary movements. *Ataxia* - **Ataxia**, particularly truncal or appendicular ataxia, is a cardinal symptom of cerebellar dysfunction [3]. - It refers to a lack of **voluntary coordination** of muscle movements, leading to an unsteady gait and impaired balance [3]. *Past-pointing* - **Past-pointing** is a form of dysmetria where a patient consistently points or reaches **beyond their target** [1]. - It is a specific sign that indicates a deficit in the cerebellum's ability to modulate and refine motor commands.
Pediatrics
1 questionsWhat is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?
NEET-PG 2013 - Pediatrics NEET-PG Practice Questions and MCQs
Question 361: What is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?
- A. Decreased muscle tone
- B. Increased muscle tone (Correct Answer)
- C. Normal phenomenon
- D. None of the options
Explanation: ***Increased muscle tone*** - The **asymmetric tonic neck reflex (ATNR)** should integrate by **6 months of age**, and its persistence beyond this period is a sign of **neurological dysfunction**. - Persistent primitive reflexes, including ATNR, are often associated with **upper motor neuron lesions** and can manifest as increased muscle tone or **spasticity**. *Decreased muscle tone* - **Decreased muscle tone**, or **hypotonia**, is typically associated with **lower motor neuron lesions** or certain genetic conditions, not the persistence of primitive reflexes. - While some neurological conditions can cause hypotonia, persistent ATNR is a hallmark of problems leading to **hypertonia**. *Normal phenomenon* - The persistence of the ATNR beyond **6 months of age** is considered abnormal and indicates a potential developmental delay or neurological issue. - In a **9-month-old**, the reflex should have fully integrated, and its presence warrants further investigation. *None of the options* - As the persistence of the ATNR is indeed a significant finding, associated with increased muscle tone, this option is incorrect.
Physiology
4 questionsWhat type of reflex is the righting reflex?
Which of the following statements is true regarding post-ganglionic parasympathetic fibers?
Cushing reflex is associated with all except?
What is the normal cerebral blood flow in milliliters per minute for a healthy adult?
NEET-PG 2013 - Physiology NEET-PG Practice Questions and MCQs
Question 361: What type of reflex is the righting reflex?
- A. Postural reflex (Correct Answer)
- B. Spinal reflex
- C. Ocular reflex
- D. Stretch reflex
Explanation: ***Postural reflex*** - The **righting reflex** is a mechanism that helps an animal or human maintain or regain their upright body position or head orientation in space, which is a key component of **postural control**. - It involves complex inputs from the **vestibular system**, visual system, and proprioceptors to adjust muscle tone and body position against gravity. - Examples include **neck righting reflex**, **body righting reflex**, and **labyrinthine righting reflex**. *Stretch reflex* - A **stretch reflex** is a monosynaptic reflex that causes a muscle to contract in response to being stretched, primarily to maintain muscle length and tone. - It does not encompass the complex, multi-sensory integration required for maintaining overall body orientation. *Spinal reflex* - A **spinal reflex** is any reflex arc whose neural circuit passes through the spinal cord, and it can be either monosynaptic or polysynaptic. - While the righting reflex involves spinal cord components, it is a broader, more integrated reflex that extends beyond a simple spinal cord circuit. *Ocular reflex* - **Ocular reflexes** are involuntary eye movements or responses, such as pupillary light reflex or vestibulo-ocular reflex, that primarily control eye position or pupil size. - They do not directly relate to the maintenance of the entire body's upright posture.
Question 362: Which of the following statements is true regarding post-ganglionic parasympathetic fibers?
- A. They originate from the spinal cord.
- B. They are part of the sympathetic nervous system.
- C. They are responsible for 'fight or flight' responses.
- D. They release acetylcholine at the target organs. (Correct Answer)
Explanation: ***They release acetylcholine at the target organs.*** - Post-ganglionic parasympathetic fibers are **cholinergic**, meaning they release the neurotransmitter **acetylcholine** at their effector organs. - This action mediates the characteristic "rest and digest" responses of the parasympathetic nervous system. *They originate from the spinal cord.* - **Pre-ganglionic parasympathetic fibers** originate from the **brainstem** (cranial nerves III, VII, IX, X) and the **sacral spinal cord** (S2-S4). - Post-ganglionic fibers originate in ganglia located near or within their target organs, not the spinal cord directly. *They are part of the sympathetic nervous system.* - Post-ganglionic parasympathetic fibers are a component of the **parasympathetic nervous system**, not the sympathetic nervous system. - The sympathetic and parasympathetic systems are distinct divisions of the autonomic nervous system with generally opposing functions. *They are responsible for 'fight or flight' responses.* - The **'fight or flight' response** is characteristic of the **sympathetic nervous system**, which prepares the body for stressful situations. - The parasympathetic nervous system is responsible for **'rest and digest' functions**, promoting energy conservation and maintenance activities.
Question 363: Cushing reflex is associated with all except?
- A. Irregular respiration
- B. Hypotension (Correct Answer)
- C. Increased intracranial pressure
- D. Bradycardia
Explanation: ***Hypotension*** - The **Cushing reflex** is a compensatory response to increased intracranial pressure (ICP) aiming to maintain cerebral perfusion, which typically involves **hypertension**, not hypotension. - While prolonged or severe ICP can lead to decompensation and eventual hypotension, it is not a direct component of the reflex itself. *Increased intracranial pressure* - The **Cushing reflex** is triggered by an elevation in **intracranial pressure (ICP)**, as the body attempts to maintain blood flow to the brain. - This increased ICP reduces cerebral perfusion pressure, prompting a systemic response to raise mean arterial pressure. *Bradycardia* - **Bradycardia** is a classic component of the **Cushing reflex**, occurring as a compensatory response to the reflex hypertension. - The increased arterial blood pressure stimulates carotid and aortic baroreceptors, leading to a vagal response that slows the heart rate. *Irregular respiration* - **Irregular respiration** is another key component of the **Cushing reflex**, often manifesting as **Cheyne-Stokes breathing** or **ataxic breathing**. - This respiratory dysregulation is due to direct compression and dysfunction of the brainstem, specifically the medullary respiratory centers, caused by increased ICP.
Question 364: What is the normal cerebral blood flow in milliliters per minute for a healthy adult?
- A. 55 ml/min
- B. 150 ml/min
- C. 750 ml/min (Correct Answer)
- D. 1000 ml/min
Explanation: ***750 ml/min*** - The brain receives approximately **15% of the cardiac output**, which for an average adult with a cardiac output of 5 L/min (5000 ml/min) translates to about **750 ml/min**. - This flow rate is essential to meet the high metabolic demands of the brain, which consumes about **20% of the body's total oxygen**. - For reference, this corresponds to approximately **50-55 ml/100g/min** when normalized to brain tissue weight. *55 ml/min* - This value represents the **cerebral blood flow per 100 grams of brain tissue** (50-55 ml/100g/min), not the **total cerebral blood flow**. - As a total flow value, 55 ml/min would be severely **inadequate** for the entire brain (~1400g) and would lead to immediate **ischemia** and neurological dysfunction. *150 ml/min* - While higher than 55 ml/min, this rate is still **grossly insufficient** to maintain the metabolic needs of the entire adult brain. - Such a low total flow would result in widespread **cerebral hypoperfusion** and severe neurological deficits. *1000 ml/min* - Although the brain has significant blood flow, 1000 ml/min is generally **higher than the normal average** for a healthy adult at rest. - The normal range is typically **750-800 ml/min**; sustained flow at 1000 ml/min might be seen in hyperemia or certain physiological states but is not the typical baseline.